Tier system ‘inadequate’ and did not contain spread of coronavirus, leading medics warn


he tiered system of coronavirus restrictions are “inadequate” and must be revised before England exits lockdown, leading medics have said.

A new system should have “triggers” whereby different areas would move up and down different tiers, according to its blueprint for leaving lockdown.

And non-essential travel between tiers in higher and lower prevalence areas should be “restricted”, the BMA added.

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Ministers have implied that the nation will return to a tiered approach when lockdown concluded on December 2.

The Government will decide next week how to end the current lockdown.

Communities Secretary Robert Jenrick said ministers want to see a “significant easing” of coronavirus controls when the lockdown is lifted. However, he suggested tighter controls may be needed in the top Tier 3.

The BMA blueprint also makes a number of other suggestions including:

– The “rule of six” should be replaced with a “rule of two households”.

– A “more robust” quarantine procedure – which could possibility include: “provision of transport for those returning home or to other locations in order to quarantine and could include facilities for quarantine close to ports of entry”.

– Criteria should be published for establishing and removing travel corridors.

– The Government should produce an “airline safety style” video telling people how to properly wear masks.

– Social mixing should be encouraged to take place outdoors.

– There should be a required 2m distance between tables in pubs and restaurants.

– More financial support for businesses to fit screens and signage.

– The “work from home where possible” message should continue.

– Masks should be worn in all indoor settings where social distancing is not possible. Face coverings should also be worn outside in some circumstances.

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The document states: “The previous tiered system was inadequate and inconsistent in the way it was applied and did not contain spread of the virus.

“The tiered system must be urgently revised, with agreed “triggers” for moving up and down a tier.

“With any reintroduction of the tiered system, the Government must clarify the rules on travel between different tiers. To prevent spread of infection, non-essential travel particularly between higher and lower prevalence areas should be restricted.”

On clearer guidance being needed for hospitality settings, the report adds: “Crowded restaurants and pubs with little social distancing, as seen after the first lockdown, encouraged by the eat out to help out initiative, represent a danger to public health.”

The BMA said that before lockdown the Government should ensure that the Test and Trace programme is fit for purpose.

“We must not squander the efforts of the many people who have followed the law, stayed at home, sacrificed freedoms and incurred financial loss in order to contain the virus,” said BMA chairman of council Dr Chaand Nagpaul.

“When the first lockdown ended, there was no coherent plan for keeping Covid-19 at bay, no clear and simple public messaging; this was followed by spiralling infection rates, more businesses failing, new ‘local’ lockdowns, and now we have a death toll at more than 52,000.

“As England prepares to exit its second lockdown, it is unthinkable that we make the same mistakes again because this time, the impact will be far worse. It’s reasonable to conclude, that without these measures, the NHS will not be able to cope with caring for even the most critically ill patients.

“This report demonstrates a sustainable plan for reducing the level of infections from COVID-19 until a vaccine programme is under way.”


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